As physicians, we have the luxury of pursuing additional training in a wide variety of clinical fields. Certificates of added qualification (CAQs) or certificates of special qualification (CSQs) are formal training programs that are affiliated with individual specialties within medicine. CAQs and CSQs are especially useful to help you establish your area of expertise in a clinical and/or an academic setting. To be eligible to pursue a qualification certificate, you must have already completed your residency training. Some fellowship programs specifically prepare their fellows to sit for a certification exam.   Whether you pursue expertise via a formal fellowship or independently, a CAQ/CSQ can be obtained by sitting for a standardized written examination. Most certificates are time-limited. Some programs have a recertification process; others require that applicants sit again for primary certification at regular intervals of five to ten years.

Specific examples of CAQs for both MDs and DOs include addiction medicine, adolescent medicine, geriatric medicine, occupational medicine, palliative care, sports medicine, and transplant hepatology, among many others. A complete list of certification type and associated specialties for DOs can be found at https://www.doonline.org/pdf/cal_hod08
res2ff2.pdf. Many of these same certifications exist for MDs as well.

In addition to formal CAQs, there are a variety of different educational opportunities that are available to all health care providers, not just physicians. A maternal-child health example of this kind of training is a week-long course to become a Certified Lactation Counselor (CLC). The next step, becoming an International Board Certified Lactation Consultant (IBCLC), is an even more rigorous process. The IBCLC designation has different eligibility criteria for physicians and non-physicians (http://www.iblce.org). Initial certification for physicians requires that they take the 40-hour CLC course, document clinical hours working with breastfeeding dyads, and then sit for a day-long exam that is offered around the world once a year in July. An IBCLC must be recertified every five years with either documentation of continuing education credits or by retaking the written examination. As of November of 2008, there are 372 US physicians who are also IBCLCs.